S-Space College of Medicine/School of Medicine (의과대학/대학원) Internal Medicine (내과학전공) Journal Papers (저널논문_내과학전공)
Combinations containing amoxicillin-clavulanate and tetracycline are inappropriate for Helicobacter pylori eradication despite high in vitro susceptibility
- Cheon, Jae Hee; Kim, Sang Gyun; Kim, Jung Mogg; Kim, Nayoung; Lee, Dong Ho; Kim, Joo Sung; Jung, Hyun Chae; Song, In Sung
- Issue Date
- J Gastroenterol Hepatol. 2006 Oct;21(10):1590-5.
- 2-Pyridinylmethylsulfinylbenzimidazoles/therapeutic use; Amoxicillin-Potassium Clavulanate Combination/*contraindications; Anti-Bacterial Agents/*contraindications; Anti-Ulcer Agents/therapeutic use; Biopsy; Bismuth/therapeutic use; Drug Therapy, Combination; Endoscopy, Gastrointestinal; Female; Helicobacter Infections/*drug therapy/microbiology/pathology; Helicobacter pylori/drug effects/*isolation & purification; Humans; Male; Metronidazole/therapeutic use; Middle Aged; Organometallic Compounds/therapeutic use; Pyloric Antrum/*microbiology/pathology; Stomach Ulcer/drug therapy/microbiology/pathology; Tetracycline/*contraindications; Treatment Failure
- BACKGROUND: The purpose of the present paper was to evaluate the efficacy and tolerability of amoxicillin-clavulanate and tetracycline-based quadruple therapy as an alternative second-line treatment for H. pylori infection. METHODS: The study subjects consisted of 54 patients infected with H. pylori, in whom initial triple therapy had failed. Subjects were randomized to receive the following 7-day therapies: (i) pantoprazole 40 mg b.i.d., tripotassium dicitrate bismuthate 300 mg q.i.d., amoxicillin-clavulanate 1000 mg b.i.d., and tetracycline 500 mg q.i.d. (PBAT); or (ii) pantoprazole 40 mg b.i.d., tripotassium dicitrate bismuthate 300 mg q.i.d., metronidazole 500 mg t.i.d., and tetracycline 500 mg q.i.d. (PBMT). Eradication rates based on antibiotic susceptibility, drug compliance and side-effect rates were evaluated and compared. RESULTS: The H. pylori eradication rates were 16.0%/17.4% with PBAT and 65.5%/70.4% with PBMT by intention-to-treat (P<0.001) and per-protocol analyses (P<0.001), respectively. In patients who received PBAT, the eradication rates were only 16.7% (2/12) for both amoxicillin and tetracycline-susceptible H. pylori strains. Drug compliance and side-effect rates were similar in the two groups. CONCLUSIONS: Despite high individual in vitro antimicrobial activity, amoxicillin-clavulanate and tetracycline-based quadruple therapy showed low eradication rates, which strongly suggests that it should not be considered as a therapeutic option for H. pylori eradication.
- 0815-9319 (Print)
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